Injectable dermal fillers are widely used by dermatologists and plastic surgeons to soften deep folds and reduce wrinkles on the faces of patients, such as lines from the nose to the corners of the mouth and “crows feet” which extend from the corners of the mouth. They are also commonly used as a lip augmentation agent and to fill in hollow places and scars on the face.
The injectable dermal fillers used in such applications are typically comprised of hyaluronic acid because it can absorb up to 1000 times its own weight in water which accordingly adds volume under the surface of sagging skin to provide a more youthful appearance. Hyaluronic acid is also believed to bind to collagen present in the skin to enhance firming. There is some evidence that hyaluronic acid stimulates additional collagen formation which is highly advantageous since collagen supports the skin structure.
Dermal fillers can also be injected into the skin of the orbital trough of a patient to firm the skin in the area around the eyes. However, this procedure is complicated by the fact that some people develop dark circles around their eyes with age. The injection of dermal fillers aggravates this problem and can cause such dark areas to have an even darker appearance due to the Tyndall effect. This is caused by the filler particles scattering the light in a manner that results in a darker appearance (black or dark blue). Accordingly, the use of dermal fillers in the orbital trough of patients that have developed dark circles around their eyes can be problematic.